ReviewEndocrine connections2022
Impact of gender-affirming treatment on bone health in transgender and gender diverse youth.
Review in Endocrine connections, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 25 citations in OpenAlex.
- Pediatric endocrine disorders: a review of intra-abdominal findings and appropriate imaging.Pediatric radiology · 2026Review
- A novel model to study the impact of gender-affirming therapy on bone in young male mice.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Nutritional Monitoring During Gender-Affirming Hormone Therapy: Body Composition and Metabolic Implications.Nutrients · 2026Review
- Striving for LGBTQI+ Health Equity in Arthroplasty.Arthroplasty today · 2026Article
- Bone Mineral Accrual From Adolescence Into Young Adulthood and Peak Bone Mass: A Longitudinal Cohort Study.Health science reports · 2025Article
- Single-Center Retrospective Analysis of Safety and Efficacy of Subcutaneous Estradiol Use in Transgender and Nonbinary Adolescents and Young Adults.Transgender health · 2025Article
- GnRH analogs as a monotherapy in transgender and gender-diverse adolescents: clinical insights from a single-center study.Endocrine connections · 2025Article
- Psychological and Physical Health Outcomes Associated with Gender-Affirming Medical Care for Transgender and Gender-Diverse Youth: A Critical Review.Healthcare (Basel, Switzerland) · 2025Review
- A Preclinical Investigation of Estrogenic Bone Protection in a Hypertensive Rat Model Under Gender-Affirming Hormone Therapy.Biology · 2025Article
- Effects of puberty suppression on bone, body composition, handgrip strength and glucolipid profile in early-pubertal transgender adolescents.International journal of transgender health · 2025Article
- Sex determination through maxillary dental arch and skeletal base measurements using machine learning.Head & face medicine · 2024Article
- Evaluation and medical care of intersex and gender diverse youth.Pediatric radiology · 2024Review
- Diagnosis and therapeutic approach to bone health in patients with hypopituitarism.Reviews in endocrine & metabolic disorders · 2024Review
- Gender-Diverse Youth with Turner Syndrome: Special Management Considerations.JCEM case reports · 2024Article
- Bone quality following peripubertal growth in a mouse model of transmasculine gender-affirming hormone therapy.bioRxiv : the preprint server for biology · 2024Article
- Effects of Early-Childhood-Based Interventions Influencing Bones: A Systematic Review.Journal of functional morphology and kinesiology · 2023Review
- Exploring Hormone Therapy Effects on Reproduction and Health in Transgender Individuals.Medicina (Kaunas, Lithuania) · 2023Review
- Best Practices for Gender-Affirming Care for Pediatric Orthopaedic Patients.Journal of the Pediatric Orthopaedic Society of North America · 2023Review
- Developmental Pathway Choices of Young People Presenting to a Gender Service with Gender Distress: A Prospective Follow-Up Study.Children (Basel, Switzerland) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Both in the United States and Europe, the number of minors who present at transgender healthcare services before the onset of puberty is rapidly expanding. Many of those who will have persistent gender dysphoria at the onset of puberty will pursue long-term puberty suppression before reaching the appropriate age to start using gender-affirming hormones. Exposure to pubertal sex steroids is thus significantly deferred in these individuals. Puberty is a critical period for bone development: increasing concentrations of estrogens and androgens (directly or after aromatization to estrogens) promote progressive bone growth and mineralization and induce sexually dimorphic skeletal changes. As a consequence, safety concerns regarding bone development and increased future fracture risk in transgender youth have been raised. We here review published data on bone development in transgender adolescents, focusing in particular on differences in age and pubertal stage at the start of puberty suppression, chosen strategy to block puberty progression, duration of puberty suppression, and the timing of re-evaluation after estradiol or testosterone administration. Results consistently indicate a negative impact of long-term puberty suppression on bone mineral density, especially at the lumbar spine, which is only partially restored after sex steroid administration. Trans girls are more vulnerable than trans boys for compromised bone health. Behavioral health measures that can promote bone mineralization, such as weight-bearing exercise and calcium and vitamin D supplementation, are strongly recommended in transgender youth, during the phase of puberty suppression and thereafter.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.